Telehealth-based prescribing of buprenorphine for treatment of patients with opioid use disorder is “safe and beneficial…and should be made available to those who need it” says Dr. Nora Volkow, director of the National Institute on Drug Abuse.
Citing new research of Medicaid patients in Kentucky and Ohio which showed that patients who were started on buprenorphine treatment via telehealth remained in treatment longer than those without access to telehealth, Dr. Volkow concluded: “To quell the unprecedented loss of life from the overdose crisis, we must continue to prioritize both increasing access to treatment and providing the care and support people need to stay in treatment after they have started.”
The study of Medicaid claims data from 2019-2020, published in JAMA Network Open, October 2023, reported that in Kentucky, 48 percent of individuals who started buprenorphine treatment via telehealth remained in treatment for 90 continuous days. Among those without access to telehealth, 44 percent stayed in treatment for 90 days. Similar findings were found among Medicaid patients studied in Ohio. The study also concluded that telehealth initiation of buprenorphine was not associated with nonfatal overdose—in effect did not harm patients.
Because telehealth technology was still relatively rare in the test years of 2020, the research team followed up with a smaller subset of individuals who started buprenorphine in the second or third quarter of 2020 and found the results consistent with the original. (The study included 41,266 individuals in Kentucky and 50,648 in Ohio).
Lindsey R. Hammerslag, PhD., assistant professor at the University of Kentucky, and lead author of the study concludes: “Our study suggests that people who have access to telehealth treatment for addiction seem to do better than those who do not. Our hope is that these findings can help inform future policy….In addition, the findings also emphasize that the benefits of telehealth are not reaching all populations equitably.”
According to a news release accompanying the JAMA publication, the National Institutes of Health noted that prior to 2020, people with opioid use disorder were required to meet in-person with a healthcare provider to start treatment with buprenorphine, but after the onset of the COVID-19 pandemic, the US government implemented prescribing flexibilities to facilitate buprenorphine access to patients with OUD.
The research was conducted as part of the HEALing Communities Study which is supported by NIDA and carried out in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) and NIH.
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